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1氧化磷酸化与糖酵解:精子以何种途径获取能量?显示文摘精子为高度特异性的细胞,提供精子重要功能的主要能源一一三磷酸腺苷(ATP)主要通过两种代谢途径形成,即糖酵解和氧化磷酸化(OXPHOS)。ATP除了在精子的头部和鞭毛的主段通过糖酵解的方式产生外,在线粒体主要通过OXPHOS的方式产生。然而,在精子成功受精的过程中主要以何种方式产生ATP具有很大的差异性。与糖酵解相比,线粒体呼吸被认为是一种更有效的ATP合成代谢过程。然而,研究表明ATP从线粒体到精子鞭毛末端的扩散电位不足以支持精子的运动,这表明糖酵解是精子尾部区域主要的获能方式。多项研究表明虽然糖酵解是鞭毛产生ATP的主要方式,但是,精子运动所需要的能量主要还是来自于线粒体的呼吸。有些研究表明当糖酵解受到抑制的时候,精子仍能维持其正常的运动和功能,虽然目前尚未明确这种运动是否能持续足够长的时间,是否能够达到有效受精。本文主要目的是对哺乳动物精子能量的代谢进行综述,分析人类精子在受精的过程中以何种ATP代谢途径作为主要的能量供应方式。Stefan S du Plessis Ashok Agarwal Gayatri Mohanty Michelle van der Linde 2015Asian Journal of Andrology2015,17,2:19
2Meta-analyses on prevalence of selected Parkinson’s nonmotor symptoms before and after diagnosis显示文摘Background:Nonmotor symptoms are common among patients with Parkinson’s disease(PD)and some may precede disease diagnosis.Methods:We conducted a meta-analysis on the prevalence of selected nonmotor symptoms before and after PD diagnosis,using random-effect models.We searched PubMed(1965 through October/November 2012)for the following symptoms:hyposmia,constipation,rapid eye movement sleep behavior disorder,excessive daytime sleepiness,depression,and anxiety.Eligible studies were publications in English with original data on one or more of these symptoms.Results:The search generated 2,373 non-duplicated publications and 332 met the inclusion criteria,mostly(n=320)on symptoms after PD diagnosis.For all symptoms,the prevalence was substantially higher in PD cases than in controls,each affecting over a third of the patients.Hyposmia was the most prevalent(75.5%in cases vs.19.1%in controls),followed by constipation(50%vs.17.7%),anxiety(39.9%vs.19.1%),rapid eye movement sleep behavior disorder(37.0%vs.7.0%),depression(36.6%vs.14.9%),and excessive daytime sleepiness(33.9%vs.10.5%).We observed substantial heterogeneities across studies and meta-regression analyses suggested that several factors might have contributed to this.However,the prevalence estimates were fairly robust in several sensitivity analyses.Only 20 studies had data on any symptoms prior to PD diagnosis,but still the analyses revealed higher prevalence in future PD cases than in controls.Conclusion:These symptoms are common among PD patients both before and after diagnosis.Further studies are needed to understand the natural history of nonmotor symptoms in PD and their etiological and clinical implications.Honglei Chen Edward J Zhao Wen Zhang Yi Lu Rui Liu Xuemei Huang Anna J Ciesielski-Jones Michele A Justice Deborah S Cousins Shyamal Peddada 2015Translational Neurodegeneration2015,4,1:18
3Platelet count/spleen diameter ratio to predict esophageal varices in Mexican patients with hepatic cirrhosis显示文摘AIM:To validate whether the platelet count/spleen size ratio can be used to predict the presence of esophageal varices in Mexican patients with hepatic cirrhosis.METHODS:This was an analytical cross-sectional study to validate the diagnostic test for hepatic cirrhosis and was performed between February 2010 and December 2011.Patients with a diagnosis of hepatic cirrhosis were included and stratified using their ChildPugh score.Biochemical parameters were evaluated,and ultrasound was used to measure the longest diameter of the spleen.The platelet count/spleen diameter ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices.Upper gastrointestinal endoscopy was used as the gold standard.Sensitivity and specificity,positive and negative predictive values,and positive and negative likelihood ratios were determined,with the cutoff points determined by receiver-operating characteristic curves.RESULTS:A total of 91 patients were included.The mean age was 53.75±12 years;50(54.9%)were men,and 41(45.0%)women.The etiology of cirrhosis included alcohol in 48(52.7%),virally induced in24(26.3%),alcoholism plus hepatitis C virus in three(3.2%),cryptogenic in nine(9.8%),and primary biliary cirrhosis in seven(7.6%).Esophageal varices were present in 73(80.2%)patients.Child-Pugh classification,17(18.6%)patients were classified as class A,37(40.6%)as class B,and 37(40.6%)as class C.The platelet count/spleen diameter ratio to detect esophageal varices independent of the grade showed using a cutoff value of≤884.3,had 84%sensitivity,70%specificity,and positive and negative predictive values of 94%and 40%,respectively.CONCLUSION:Our results suggest that the platelet count/spleen diameter ratio may be a useful tool for detecting esophageal varices in patients with hepatic cirrhosis.Alejandro González-Ojeda Gabino Cervantes-Guevara Manuela Chávez-Sánchez Carlos Dávalos-Cobián Susana Ornelas-Cázares Michel Dassaejv Macías-Amezcua Mariana Chávez-Tostado Kenia Militzi Ramírez-Campos Anaís del Rocío Ramírez-Arce Clotilde Fuentes-Orozco 2014World Journal of Gastroenterology2014,20,8:18
4Clinical Management of Hepatocellular Carcinoma. Conclusions of the Barcelona-2000 EASL Conference显示文摘Jordi Bruix Morris Sherman Josep M Llovet Michel Beaugrand Riccardo Lencioni Andrew K Burroughs Erik Christensen Luigi Pagliaro Massimo Colombo Juan Rodés 2001Journal of Hepatology2001,,3:11
5大气二氧化氮与每日总死亡率、心血管和呼吸系统疾病死亡率的短期关联:398个城市的多中心分析显示文摘目的:采用统一的分析方案,评估全球多个国家/地区的二氧化氮(NO_(2))与总死亡率、心血管和呼吸系统疾病死亡率之间的短期关联。研究设计:采用两阶段的时间序列分析方法、过度离散的广义线性模型和多水平meta分析。研究地点:22个低到高收入国家/地区的398个城市。主要结局指标:1973—2018年逐日总死亡人数(6280万人)、心血管疾病死亡人数(1970万人)和呼吸系统疾病死亡人数(550万人)。结果:平均而言,NO_(2)浓度在滞后1天(前1天)每增加10μg/m^(3),会导致总死亡率、心血管和呼吸系统疾病死亡率分别增加0.46%(95%可信区间0.36%~0.57%)、0.37%(0.22%~0.51%)、0.47%(0.21%~0.72%)。在对共污染物(PM_(10)、PM_(2.5)、臭氧、二氧化硫和一氧化碳)进行调整后,这些关联仍然很稳定。所有3种死因的暴露-反应曲线几乎是线性的,没有明显的阈值。在398个城市中,可归因于高过假定零水平的NO_(2)浓度造成的死亡比例为1.23%(95%可信区间0.96%~1.51%)。结论:这项多中心研究提供了关于NO_(2)短期暴露与总死亡率、心血管和呼吸系统死亡风险之间的独立和线性关联的关键证据,说明通过加强NO_(2)的控制和监管限制标准,可获得人群水平的健康收益。孟夏 刘聪(校) 陈仁杰 郑湃(译) 阚海东(校) Francesco Sera Ana Vicedo-Cabrera Ai Milojevic Maria Guo Yuming Tong Shilu Micheline de Sousa Zanotti Stagliorio Coelh Paulo Hilario Nascimento Saldiva Eric Lavigne Patricia Matus Correa Nicolas Valdes Ortega Samuel Osorio Garcia Jan Kysely Ales Urban Hans Orru Marek Maasikmets Jouni J K Jaakkola Niilo Ryti Veronika Huber Alexandra Schneider Klea Katsouyanni Antonis Analitis Masahiro Hashizume Yasushi Honda Chris Fook Sheng Ng Baltazar Nunes João Paulo Teixeira Iulian Horia Holobaca Simona Fratianni Ho Kim Aurelio Tobias Carmeníniguez Bertil Forsberg ChristoferÅström Martina S Ragettli Yue-Liang Leon Guo Shih-Chun Pan Shanshan Li Michelle L Bell Antonella Zanobetti Joel Schwartz Tangchun Wu Antonio Gasparrini 2021英国医学杂志中文版2021,24,8:7
6Liver insulin-like growth factor 2 methylation in hepatitis C virus cirrhosis and further occurrence of hepatocellular carcinoma显示文摘AIM: To assess the predictive value of the insulinlike growth factor 2 (Igf2) methylation profile for the occurrence of Hepatocellular Carcinoma (HCC) in hepatitis C (HCV) cirrhosis. METHODS: Patients with: (1) biopsy-proven compensated HCV cirrhosis; (2) available baseline frozen liver sample; (3) absence of detectable HCC; (4) regular screening for HCC; (5) informed consent for genetic analysis were studied. After DNA extraction from liver samples and bisulfite treatment, unbiased PCR and DHPLC analysis were performed for methylation analysis at the Igf2 locus. The predictive value of the Igf2 methylation profile for HCC wasassessed by Kaplan-Meier and Cox methods. RESULTS: Among 94 included patients, 20 developed an HCC during follow-up (6.9 ± 3.2 years). The methylation profile was hypomethylated, intermediate and hypermethylated in 13, 64 and 17 cases, respectively. In univariate analysis, two baseline parameters were associated with the occurrence of HCC: age (P = 0.01) and prothrombin (P = 0.04). The test of linear tendency between the three ordered levels of Igf2 methylation and probability of HCC occurrence was significant (Log Rank, P = 0.043; Breslow, P = 0.037; Tarone-Ware, P = 0.039). CONCLUSION: These results suggest that hypomethylation at the Igf2 locus in the liver could be predictive for HCC occurrence in HCV cirrhosis.Philippe Couvert Alain Carrié Jacques Pariès Jenny Vaysse Audrey Miroglio Antoine Kerjean Pierre Nahon Jamel Chelly Jean-Claude Trinchet Michel Beaugrand Nathalie Ganne-Carrié 2008World Journal of Gastroenterology2008,14,35:6
7c-Fos overexpression increases the proliferation of human hepatocytes by stabilizing nuclear Cyclin D1显示文摘AIM: To investigate the effect of stable c-Fos overexpression on immortalized human hepatocyte (IHH) proliferation. METHODS: IHHs stably transfected with c-Fos (IHH-Fos) or an empty vector (IHH-C) were grown in medium supplemented with 1% serum or stimulated with 10% serum. Cell proliferation was assessed by cell counts, 3H-thymidine uptake and fl ow cytometry analyses. The levels of cell cycle regulatory proteins (Cyclin D1, E, A) cyclin dependent kinases (cdk) cdk2, cdk4, cdk6, and their inhibitors p15, p16, p21, p27, to- tal and phosphorylated GSK-3β and epidermal growth factor receptor (EGF-R) were assayed by Western blot- ting. Analysis of Cyclin D1 mRNA levels was performed by reverse transcription-polymerase chain reaction and real-time polymerase chain reaction (PCR) analysis. Stability of Cyclin D1 was studied by cycloheximide blockade experiments. RESULTS: Stable c-Fos overexpression increased cell proliferation under low serum conditions and resulted in a two-fold increase in [3H]-thymidine incorpora- tion following serum addition. Cell cycle analysis by fl ow cytometry showed that c-Fos accelerated the cell cycle kinetics. Following serum stimulation, Cyclin D1 was more abundantly expressed in c-Fos overexpressing cells. Cyclin D1 accumulation did not result from increased transcriptional activation, but from nuclear stabilization. Overexpression of c-Fos correlated with higher nuclear levels of inactive phosphorylated GSK- 3β, a kinase involved in Cyclin D1 degradation and higher levels of EGF-R mRNA, and EGF-R protein compared to IHH-C both in serum starved, and in serum stimulated cells. Abrogation of EGF-R signalling in IHH- Fos by treatment with AG1478, a specif ic EGF-R tyrosine kinase inhibitor, prevented the phosphorylation of GSK-3β induced by serum stimulation and decreased Cyclin D1 stability in the nucleus. CONCLUSION: Our results clearly indicate a positive role for c-Fos in cell cycle regulation in hepatocytes. Importantly, we delineate a new mechanism by which c-Fos could contribute to hepatocarcinogenesis through stabilization of Cyclin D1 within the nucleus, evoking a new feature to c-Fos implication in hepatocellular carcinoma.Meryem Güller Kahina Toualbi-Abed Agnès Legrand Laurence Michel Alain Mauviel Dominique Bernuau Fanny Daniel 2008World Journal of Gastroenterology2008,14,41:6
8Donation after cardio-circulatory death liver transplantation显示文摘The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ supply and following the request of potential DCD families. Since then, DCD organ procurement and transplantation activities have rapidly expanded, particularly for nonvital organs, like kidneys. In liver transplantation (LT), DCD donors are a valuable organ source that helps to decrease the mortality rate on the waiting lists and to increase the availability of organs for transplantation despite a higher risk of early graft dysfunction, more frequent vascular and ischemia-type biliary lesions, higher rates of re-listing and re-transplantation and lower graft survival, which are obviously due to theinevitable warm ischemia occurring during the declaration of death and organ retrieval process. Experimental strategies intervening in both donors and recipients at different phases of the transplantation process have focused on the attenuation of ischemia-reperfusion injury and already gained encouraging results, and some of them have found their way from pre-clinical success into clinical reality. The future of DCD-LT is promising. Concerted efforts should concentrate on the identification of suitable donors (probably Maastricht category Ⅲ DCD donors), better donor and recipient matching (high risk donors to low risk recipients), use of advanced organ preservation techniques (oxygenated hypothermic machine perfusion, normothermic machine perfusion, venous systemic oxygen persufflation), and pharmacological modulation (probably a multi-factorial biologic modulation strategy) so that DCD liver allografts could be safely utilized and attain equivalent results as DBD-LT.Hieu Le Dinh Arnaud de Roover Abdour Kaba Séverine Lauwick Jean Joris Jean Delwaide Pierre Honoré Michel Meurisse Olivier Detry 2012World Journal of Gastroenterology2012,18,33:6
9Safety and Efficacy of Antigen-Specific Regulatory T-Cell Therapy for Patients With Refractory Crohn’s Disease显示文摘Pierre Desreumaux Arnaud Foussat Matthieu Allez Laurent Beaugerie Xavier Hébuterne Yoram Bouhnik Maria Nachury Valérie Brun Hervé Bastian Nathalie Belmonte Michel Ticchioni Agnès Duchange Patricia Morel–Mandrino Virginie Neveu Nathalie Clerget–Chossat Mig 2012Gastroenterology2012,,5:4
10Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study显示文摘Shamir R Mehta Salim Yusuf Ron JG Peters Michel E Bertrand Basil S Lewis Madhu K Natarajan Klas Malmberg Hans-Jürgen Rupprecht Feng Zhao Susan Chrolavicius Ingrid Copland Keith AA Fox 2001The Lancet . 2001 (9281)2001,,9281:4
11Neutrophil transcriptional profile changes during transii from bone marrow to sites of inflammation显示文摘Flavia S Lakschevitz Michelle B Visser Chunxiang Sun Michael Glogauer 2015Cellular & Molecular Immunology2015,12,1:3
12Assessment of Methods for Determining Bioavailability of Trace Elements in Soils: A Review显示文摘Trace element-contaminated soils(TECSs) are one of the consequences of the past industrial development worldwide. Excessive exposure to trace elements(TEs) represents a permanent threat to ecosystems and humans worldwide owing to the capacity of metal(loid)s to cross the cell membranes of living organisms and of human epithelia, and their interference with cell metabolism.Quantification of TE bioavailability in soils is complicated due to the polyphasic and reactive nature of soil constituents. To unravel critical factors controlling soil TE bioavailability and to quantify the ecological toxicity of TECSs, TEs are pivotal for evaluating excessive exposure or deficiencies and controlling the ecological risks. While current knowledge on TE bioavailability and related cumulative consequences is growing, the lack of an integrated use of this concept still hinders its utilization for a more holistic view of ecosystem vulnerability and risks for human health. Bioavailability is not generally included in models for decision making in the appraisal of TECS remediation options. In this review we describe the methods for determining the TE bioavailability and technological developments, gaps in current knowledge, and research needed to better understand how TE bioavailability can be controlled by sustainable TECS management altering key chemical properties, which would allow policy decisions for environmental protection and risk management.Jurate KUMPIENE Laura GIAGNONI Bernd MARSCHNER Sébastien DENYS Michel MENCH Kristin ADRIAENSEN Jaco VANGRONSVELD Markus PUSCHENREITER Giancarlo RENELLA 2017Pedosphere2017,27,3:3
13rate of adverse events of gastroduodenal snare polypectomy for non-flat polyp is low: A prospective and multicenter study显示文摘AIM To evaluate the rate of adverse events(AEs) during consecutive gastric and duodenal polypectomies in several Spanish centers. METHODS Polypectomies of protruded gastric or duodenal polyps ≥ 5 mm using hot snare were prospectively included. Prophylactic measures of hemorrhage were allowed in predefined cases. AEs were defined and graded according to the lexicon recommended by the American Society for Gastrointestinal Endoscopy. Patients were followed for 48 h, one week and 1 mo after theprocedure. RESULTS308 patients were included and a single polypectomy was performed in 205. Only 36(11.7%) were on prior anticoagulant therapy. Mean polyp size was 15 ± 8.9 mm(5-60) and in 294 cases(95.4%) were located in the stomach. Hemorrhage prophylaxis was performed in 219(71.1%) patients. Nine patients presented AEs(2.9%), and 6 of them were bleeding(n = 6, 1.9%)(in 5 out of 6 AE, different types of endoscopic treatment were performed). Other 24 hemorrhagic episodes could be managed without any change in the outcome of the endoscopy and, consequently, were considered incidents. We did not find any independent risk factor of bleeding.CONCLUSION Gastroduodenal polypectomy using prophylactic measures has a rate of AEs small enough to consider this procedure a safe and effective method for polyp resection independently of the polyp size and location.Henry Córdova Lidia Argüello Carme Loras Antonio Naranjo Rodríguez Faust Riu Pons Joan B Gornals David Nicolás-Pérez Xavier Andújar Murcia Luis Hernández Santos Santolaria Carles Leal Carles Pons Enrique Pérez-Cuadrado-Robles Orlando García-Bosch Michel Papo Berger José Luis Ulla Rocha Cristina Sánchez-Montes Gloria Fernández-Esparrach 2017World Journal of Gastroenterology2017,23,47:3
14Towards a standard diet-induced and biopsy-confirmed mouse model of non-alcoholic steatohepatitis: Impact of dietary fat source显示文摘BACKGROUND The trans-fat containing AMLN(amylin liver non-alcoholic steatohepatitis,NASH)diet has been extensively validated in C57BL/6J mice with or without the Lep^ob/Lep^ob(ob/ob)mutation in the leptin gene for reliably inducing metabolic and liver histopathological changes recapitulating hallmarks of NASH.Due to a recent ban on trans-fats as food additive,there is a marked need for developing a new diet capable of promoting a compatible level of disease in ob/ob and C57BL/6J mice.AIM To develop a biopsy-confirmed mouse model of NASH based on an obesogenic diet with trans-fat substituted by saturated fat.METHODS Male ob/ob mice were fed AMLN diet or a modified AMLN diet with trans-fat(Primex shortening)substituted by equivalent amounts of palm oil[Gubra amylin NASH,(GAN)diet]for 8,12 and 16 wk.C57BL/6J mice were fed the same diets for 28 wk.AMLN and GAN diets had similar caloric content(40%fat kcal),fructose(22%)and cholesterol(2%)level.RESULTS The GAN diet was more obesogenic compared to the AMLN diet and impaired glucose tolerance.Biopsy-confirmed steatosis,lobular inflammation,hepatocyte ballooning,fibrotic liver lesions and hepatic transcriptome changes were similar in ob/ob mice fed the GAN or AMLN diet.C57BL/6J mice developed a mild to moderate fibrotic NASH phenotype when fed the same diets.CONCLUSION Substitution of Primex with palm oil promotes a similar phenotype of biopsyconfirmed NASH in ob/ob and C57BL/6J mice,making GAN diet-induced obese mouse models suitable for characterizing novel NASH treatments.Michelle L Boland Denise Oro Kirstine S T■lb■l Sebastian T Thrane Jens Christian Nielsen Taylor S Cohen David E Tabor Fiona Fernandes Andrey Tovchigrechko Sanne S Veidal Paul Warrener Bret R Sellman Jacob Jelsing Michael Feigh Niels Vrang James L Trevaskis Henrik H Hansen 2019World Journal of Gastroenterology2019,25,33:3
15中国西部降水中δD及相关气候研究显示文摘田立德 Michel,S 1999冰川冻土1999,21,4:3
16Pharmacology of adapalene 显示文摘Michel S Jomard A Demarchez M 1998Br J Dermatol1998,139,52:2
17Psychosocial mechanisms for the transmission of somatic symptoms from parents to children显示文摘AIM: To examine familial aggregation of irritable bowel syndrome(IBS) via parental reinforcement/modeling of symptoms, coping, psychological distress, and exposure to stress.METHODS:Mothers of children between the ages of8 and 15 years with and without IBS were identified through the Group Health Cooperative of Puget Sound.Mothers completed questionnaires,including the Child Behavior Checklist(child psychological distress),the Family Inventory of Life Events(family exposure to stress),SCL-90R(mother psychological distress),and the Pain Response Inventory(beliefs about pain).Children were interviewed separately from their parents and completed the Pain Beliefs Questionnaire(beliefs about pain),Pain Response Inventory(coping)and Child Symptom Checklist[gastrointestinal(GI)symptoms].In addition,health care utilization data was obtained from the automated database of Group Health Cooperative.Mothers with IBS(n=207)and their 296 children were compared to 240 control mothers and their 335 children,while controlling for age and education.RESULTS:Hypothesis 1:reinforcement of expression of GI problems is only related to GI symptoms,but not others(cold symptoms)in children.There was no significant correlation between parental reinforcement of symptoms and child expression of GI or other symptoms.Hypothesis 2:modeling of GI symptomsis related to GI but not non-GI symptom reporting in children.Children of parents with IBS reported more non-GI(8.97 vs 6.70,P<0.01)as well as more GI(3.24 vs 2.27,P<0.01)symptoms.Total health care visits made by the mother correlated with visits made by the child(rho=0.35,P<0.001 for cases,rho=0.26,P<0.001 for controls).Hypothesis 3:children learn to share the methods of coping with illness that their mothers exhibit.Methods used by children to cope with stomachaches differed from methods used by their mothers.Only 2/16 scales showed weak but significant correlations(stoicism rho=0.13,P<0.05;acceptance rho=0.13,P<0.05).Hypothesis 4:mothers and children share psychological traits such as anxiety,depression,and somatization.Child psychological distress correlated with mother’s psychological distress(rho=0.41,P<0.001 for cases,rho=0.38,P<0.001 for controls).Hypothesis 5:stress that affects the whole family might explain the similarities between mothers and their children.Family exposure to stress was not a significant predictor of children’s symptom reports.Hypothesis 6:the intergenerational transmission of GI illness behavior may be due to multiple mechanisms.Regression analysis identified multiple independent predictors of the child’s GI complaints,which were similar to the predictors of the child’s non-GI symptoms(mother’s IBS status,child psychological symptoms,child catastrophizing,and child age).CONCLUSION:Multiple factors influence the reporting of children’s gastrointestinal and non-gastrointestinal symptoms.The clustering of illness within families is best understood using a model that incorporates all these factors.Miranda AL van Tilburg Rona L Levy Lynn S Walker Michael Von Korff Lauren D Feld Michelle Garner Andrew D Feld William E Whitehead 2015World Journal of Gastroenterology2015,21,18:2
18Peripheral interventions and antiplatelet therapy: Role in current practice显示文摘Peripheral arterial disease(PAD) is a common disorder associated with a high risk of cardiovascular mortality and continues to be under-recognized. The major risk factors for PAD are similar to those for coronary and cerebrovascular disease. Management includes exercise program, pharmacologic therapy and revascularization including endovascular and surgical approach. The optimal revascularization strategy, endovascular or surgical intervention, is often debated due to the paucity of head to head randomized controlled studies. Despite significant advances in endovascular interventions resulting in increased utilization over surgical bypass, significant challenges still remain. Platelet activation and aggregation after percutaneous transluminal angioplasty of atherosclerotic arteries are important risk factors for re-occlusion/restenosis and life-threatening thrombosis following endovascular procedures. Antiplatelet agents are commonly prescribed to reduce the risk of myocardial infarction, stroke and death from cardiovascular causes in patients with PAD. Despite an abundance of data demonstrating efficacy of antiplatelet therapy in coronary artery disease and cerebrovascular disease, there is a paucity of clinical information, clinical guidelines and randomized controlled studies in the PAD population. Hence, data on antiplatelet therapy in coronary interventions is frequently extrapolated to peripheral interventions. The aim of this review article is to elucidate the current data on revascularization and the role and duration of antiplatelet and anticoagulant therapy in re-vascularized lower limb PAD patients.Pahul Singh Yenal Harper Carrie S Oliphant Mohamed Morsy Michelle Skelton Raza Askari Rami N Khouzam 2017World Journal of Cardiology2017,9,7:2
19Appropriateness of systemic treatments in unresectable metastatic well-differentiated pancreatic neuroendocrine tumors显示文摘AIM:To evaluate systemic treatment choices in unresectable metastatic well-differentiated pancreatic neuroendocrine tumors(PNETs)and provide consensus treatment recommendations.METHODS:Systemic treatment options for pancreatic neuroendocrine tumors have expanded in recent years to include somatostatin analogs,angiogenesis inhibitors,inhibitors of mammalian target of rapamycinand cytotoxic agents.At this time,there is little data to guide treatment selection and sequence.We therefore assembled a panel of expert physicians to evaluate systemic treatment choices and provide consensus treatment recommendations.Treatment appropriateness ratings were collected using the RAND/UCLA modified Delphi process.After studying the literature,a multidisciplinary panel of 10 physicians assessed the appropriateness of various medical treatment scenarios on a 1-9 scale.Ratings were done both before and after an extended discussion of the evidence.Quantitative measurements of agreement were made and consensus statements developed from the second round ratings.RESULTS:Specialties represented were medical and surgical oncology,interventional radiology,and gastroenterology.Panelists had practiced for a mean of15.5 years(range:6-33).Among 202 rated scenarios,disagreement decreased from 13.2%(26 scenarios)before the face-to-face discussion of evidence to 1%(2)after.In the final ratings,46.5%(94 scenarios)were rated inappropriate,21.8%(44)were uncertain,and30.7%(62)were appropriate.Consensus statements from the scenarios included:(1)it is appropriate to use somatostatin analogs as first line therapy in patients with hormonally functional tumors and may be appropriate in patients who are asymptomatic;(2)it is appropriate to use everolimus,sunitinib,or cytotoxic chemotherapy therapy as first line therapy in patients with symptomatic or progressive tumors;and(3)beyond first line,these same agents can be used.In patients with uncontrolled secretory symptoms,octreotide LAR doses can be titrated up to 60 mg every4 wk or up to 40 mg every 3 or 4 wk.CONCLUSION:Using the Delphi process allowed physician experts to systematically obtain a consensus on the appropriateness of a variety of medical therapies in patients with PNETs.Jonathan R Strosberg George A Fisher Al B Benson Lowell B Anthony Bulent Arslan John F Gibbs Edward Greeno Renuka V Iyer Michelle K Kim William J Maples Philip A Philip Edward M Wolin Dasha Cherepanov Michael S Broder 2015World Journal of Gastroenterology2015,21,8:2
20Arterial Stiffness Is Regulated by Nitric Oxide and Endothelium-Derived Hyperpolarizing Factor During Changes in Blood Flow in Humans显示文摘Jeremy Bellien Julie Favre Michele Iacob Ji Gao Christian Thuillez Vincent Richard Robinson Joannidès 2010Hypertension2010,,3:2
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